5/21/2018. Speakers. Objectives Continuing Education Credits. Webinar handouts. Questions during the webinar?
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1 Tick-borne Diseases: What NJ Public Health Professionals Need to Know Speakers Kim Cervantes, Vectorborne Disease Program Coordinator, New Jersey Department of Health Andrea Egizi, Research Scientist, Tick-borne Disease Laboratory, Monmouth County Mosquito Control Division and Visiting Professor, Rutgers University Center for Vector Biology Jim Occi, Doctoral Student, Rutgers University Center for Vector Biology and Research Teaching Specialist, NJ Medical School Krista Reale, Vectorborne Disease Health Educator, New Jersey Department of Health Objectives Continuing Education Credits 1 Name major tick species in New Jersey and explain tick ecology and tick biology 2 Recognize current and previous tick surveillance methods in New Jersey 3 Review a state summary of human tick-borne disease trends 4 List education resources and strategies to promote tick-borne disease prevention Credits offered for this webinar: 1. Public Health Pesticide recertification credits (8A & 8B) Credits provided to those who attend the webinar live Must also be registered on Go To Webinar and NJLMN to be eligible for PH credits NOTE: Those viewing the webinar in the archived version are not eligible to receive continuing education credits. Questions during the webinar? All attendee lines are muted. Please use the Question box to ask a question. Questions will be answered at the end of the webinar, time permitting. Webinar handouts Handouts (slides and resources) may be accessed in the Handouts box. Handouts on Go To Webinar are only available during live webinars Handouts also posted to NJLMN in Practice Exchange 1
2 You will be sent a link to the evaluation Reminder After the webinar Those seeking continuing education credits MUST complete the evaluation within 5 days Evaluation link closes after 5 days Those who do not complete the evaluation will not receive credits You must be registered on both Go to Webinar and NJLMN for PH credits Complete the evaluation for continuing education credits Attendance verified on NJLMN and Go to Webinar Tick-borne Diseases: What NJ Public Health Professionals Need to Know Topics Covered: The major tick species in New Jersey Tick ecology (where and when ticks are found) Tick biology (feeding, reproduction, life stages) James Occi Doctoral Candidate Center for Vector Biology Department of Entomology and Research Microbiologist New Jersey Medical School james.occi@rutgers.edu Thomas J. Moore, Rocky Mountain Labs Three Most Abundant Indigenous Species in New Jersey 1 mm Dermacentor variabilis American dog tick Blacklegged tick, Ixodes scapularis Female, male, nymph Ixodes scapularis blacklegged tick j. occi nymphs male j. occi American dog ticks, Dermacentor variabilis Female, male female j. occi Lone star tick, Amblyomma americanum Female, male nymph Not photographed to scale, see mm ruler Scale = mm 2
3 Amblyomma americanum Ixodes scapularis (blacklegged tick), female, male and two nymphs Scale = mm Ticks and Poppy Seeds Poll Question #1 Ixodes scapularis nymph, male, female Which stage of the blacklegged tick (Ixodes scapularis) is the size of a poppy seed? Poppy seeds Haemaphysalis longicornis nymph, female How small is a blacklegged tick nymph? I. scapularis life cycle Ixodid tick life cycle basics: egg larva nymph adult Feed once per stage. If a tick feeds on an infected host and becomes infected, it will carry that infection to subsequent stages (transstadial) and can now infect new hosts. 3
4 Ixodes scapularis Nymphal (May-July) and larval (Aug-Sept) environment Dermacentor variabilis, American dog tick Long Beach Island (Ocean Co.) 194 Dermacentor variabilis in 4 min Adult I. scapularis season and environment 55 Dermacentor variabilis 15 min. Stokes State Forest (Sussex Co.) Amblyomma americanum collections How does a tick find its host? Amblyomma americanum: 51 nymphs and 16 adults ~ 2 Tuckerto, NJ Ocean Co Dermacentor variabilis (J. Occi) R. Robbins 14 D. variabilis, 11 A. americanum ~ 4 Shark River Pk, Monmouth Co. Ixodes scapularis (J. Occi) Amblyomma americanum (J. Occi) Feeding and pathogen transmission Poll Question #2 12 hr 1 day SAT (saliva-assisted transmission) Vasodilators Platelet inhibitors Anticoagulants Thrombin inhibitors Kininases True or False? Ticks feed just like mosquitoes and can complete blood feeding in less than a minute. 2 days 4 days Ixodes scapularis J. Occi unengorged replete 4
5 Resources Fact sheets from Rutgers New Jersey Agricultural Experiment Station American Dog Tick FS: Lone Star Tick FS: Preventing tick bites fact sheet: NJDoH Tick-borne Disease Pamphlet: -tick-borne_diseases_brochure.pdf Tick Management Handbook: University of Rhode Island Tick Resource Web Site: Centers for Disease Control and Prevention Tick page: Monmouth County Mosquito Control: Companion Animal Parasite Council Prevalence Maps: My web site with tick images: (scroll down to Ticks of the World ) Jim Occi PhD Candidate Center for Vector Biology/Rutgers Entomology Research Microbiologist New Jersey Medical School and james.occi@rutgers.edu J. Occi Center for Vector Biology, Rutgers Ticks before Lyme disease 1938 Tick surveillance in New Jersey: Past and Present Andrea M. Egizi, PhD Tick-borne Disease Laboratory, Monmouth County Center for Vector Biology, Rutgers University No mention of blacklegged ticks Ticks after Lyme disease First Lyme disease case in NJ = 1978 Deer surveys: Last statewide survey Ticks collected from hunter-killed white-tailed deer in 22 p=.1 p <.1 p <.1 p=.337 Schulze et al Egizi et al. 218 Ticks and Tick-borne Diseases 5
6 Total submissions, /21/218 Last statewide survey Ticks collected from hunter-killed white-tailed deer in 22 Monmouth County Program Active surveillance Passive surveillance Borrelia miyamotoi Avg infection 2.7% Education Egizi et al. 218 Ticks and Tick-borne Diseases Who gets bitten by ticks? (Human) Host sex Male 53% Host species Human 95% Female 47% Other <1% DOG 5% % 7,725 ticks acquired in MC Other includes 11 cats, 8 rabbits and 1 chicken. (Human) Host Age Jordan et al. unpublished- do not distribute Where do people get bitten? Location where tick acquired Other 11% Home 59% Park 24% School 6% Activity where tick acquired Recreation 7% Yardwork 21% Over 5: 56% Employment 3% Other 6% Jordan et al. unpublished- do not distribute Poll slide When do people get bitten? A. americanum D. variabilis I. scapularis tick season Jordan et al. unpublished- do not distribute 6
7 Total Submissions Passive Surveillance Submissions Field Collections (ticks/1 sq.m.) 5/21/218 Which ticks are biting? Other species, 1x each Rhipicephalus sanguineus Ixodes cookei Ixodes dentatus Rise of the lone star tick y = x R² =.3684 P =.48 y = x R² =.761 P <.1 y = 41.8x R² =.8157 P <.1 Expanded north in Monmouth and beyond Longer season in recent years Compared to blacklegged ticks Significantly more lone stars coming in as nymphs Significantly more lone stars are coming in fed I. scapularis A. americanum D. variabilis Jordan et al. unpublished- do not distribute Schulze et al. (211) Implications: Ehrlichiosis Based on relative tick abundance and infection rates, Ehrlichiosis should occur.64x as often as Lyme disease Lyme cases in Monmouth in 216: 492 Expected Ehrlichiosis cases:.64 * 492 = 297 Actual Ehrlichiosis cases: 6! Human-tick encounters do not always reflect field abundance! Passive data from Colts Neck, Tinton Falls, Howell and Wall (surrounding NWS Earle) Underreported? Asymptomatic? Egizi et al. 217 Emerg Infect Dis Both?? NWSE - AA Passive AA Jordan et al. unpublished- do not distribute Species to watch for Amblyomma maculatum Collected in Maryland, Delaware in 213 Vector of Rickettsia parkeri Poll slide? 7
8 Species to watch for Longhorned tick (Haemaphysalis longicornis) Native to east Asia, invasive in Australia and New Zealand Detected on Hunterdon County sheep with no travel history in 217 Longhorned tick detections As of 5/17/218 Hunterdon County (sheep, grass, deer) Union County (grass) Middlesex County (grass) And on May 16, Virginia (calf)! Rainey et al. 218 J Med Entomol 218 NJ Tick Blitz Funding from Northeast IPM Center Organized by Rutgers Center for Vector Biology and Monmouth County Tick-borne Diseases Laboratory Participants: 21 county mosquito control agencies 218 NJ Tick Blitz Data analysis is ongoing Hoping to identify distribution of: American dog ticks Spotted fever rickettsia Gulf coast tick Invasive longhorned tick Stay tuned! Photos from Jonathan Cassidy (Burlington) OVERVIEW TICKBORNE DISEASE TRENDS KIM CERVANTES, MA, MPH, CIC VECTOR-BORNE DISEASE COORDINATOR, NJDOH Overall tickborne disease trends Diseases transmitted by Ixodes scapularis (deer tick) Amblyomma americanum (lone star tick) Dermacentor variabilis (american dog tick) New tick on the block - Haemaphysalis longicornis (longhorned tick) 8
9 # CASES 5/21/218 6 Tickborne Diseases (combined), NJ, by Year, YEAR IXODES SCAPULARIS (DEER TICK, BLACKLEGGED TICK) TRANSMITTED DISEASES 6 Lyme Disease Cases by Year Select Tickborne Diseases Transmitted by Deer Ticks, NJ, by Year Lyme disease (Borrelia burgdorferi, B. mayonii) Borrelia miyamotoi Anaplasmosis Babesiosis Powassan Anaplasmosis Babesiosis Powassan ANAPLASMOSIS, BABESIOSIS, LYME DISEASE 5-YEAR INCIDENCE RATES BY COUNTY, (PER 1, POPULATION) 9
10 AMBYLOMMA AMERICANUM (LONE STAR TICK) TRANSMITTED DISEASES DERMACENTORVARIABILIS (AMERICAN DOG TICK) TRANSMITTED DISEASES NJ Ehrlichiosis Cases, by Year Ehrichiosis (E. chaffensis, E. ewingii) Tularemia Heartland virus Spotted Fever Group Rickettsiosis STARI NJ SFGR Cases, by Year Spotted Fever Group Rickettsiosis (SFGR) Rocky Mountain Spotted Fever Tularemia EHRLICHIOSIS AND SPOTTED FEVER GROUP RICKETTSIOSIS 5-YEAR INCIDENCE RATES BY COUNTY, (PER 1, POPULATION) HUMAN HEALTH IMPACT OF HAEMAPHYSALIS LONGICORNIS (LONGHORNED TICK) Impact on human health in NJ is as yet unknown Ticks identified in Hunterdon, Union, and Middlesex counties Human pathogen testing so far negative Southeast Asia associated with Rickettsia japonica, Severe fever with thrombocytopenia syndrome virus, Powassan, and Huaiyangshan virus hemorrhagic fever Surveillance is ongoing NJ LONGHORNED TICK RESPONSE IN CONCLUSION Partners: NJDA (lead agency); NJDEP, NJDOH, Rutgers University Center for Vector Biology, Hunterdon County Division of Health Services, USDA, CDC, SCWDS Outreach with livestock owners, veterinarians, slaughterhouses Wildlife surveillance Tick surveillance Focal treatment Information and education Public tick submission/drop-off INFORMATION: s html NJ Tick Line Coming Soon Tickborne diseases in NJ are increasing Cases are under-reported! Rare diseases (B. miyamotoi, Powassan, Bourbon virus, Heartland virus) rely on clinician awareness and specialized testing Travelers and ticks are on the move Human AND tick surveillance are needed to identify new pathogens and monitor ones we know about 1
11 NJDOH resources for the public Tickborne Diseases brochure Print copies available! Education resources & strategies KRISTA M. REALE MA, C HES NEW JERSEY DEPARTMENT OF HEALTH Tick Safety Tips video How to Remove a Tick flyer How to Avoid Tick Bites flyer Resources for professionals Tick Management Handbook (Connecticut Agricultural Experiment Station) Tickborne Diseases of the United States: A Reference Manual for Health Care Providers (CDC) Education strategies Local community presentations, health fairs, etc. May is Lyme Disease Awareness Month NJDOH Websites / Disease Chapters Social Tickborne Disease Basics toolkit (NJDOH) Press Release / Health Alert Network Messaging NJDOH Reportable Disease Statistics Education strategies Local community presentations, health fairs, etc. Education strategies Local community presentations, health fairs, etc. May is Lyme Disease Awareness Month May is Lyme Disease Awareness Month NJDOH Websites / Disease Chapters NJDOH Websites / Disease Chapters Social Social Press Release / Health Alert Network Messaging Press Release / Health Alert Network Messaging NJDOH Reportable Disease Statistics NJDOH Reportable Disease Statistics 11
12 Jim 5/21/218 Education strategies Local community presentations, health fairs, etc. Education strategies Local community presentations, health fairs, etc. May is Lyme Disease Awareness Month May is Lyme Disease Awareness Month NJDOH Websites / Disease Chapters NJDOH Websites / Disease Chapters Social Social Press Release / Health Alert Network Messaging Press Release / Health Alert Network Messaging NJDOH Reportable Disease Statistics NJDOH Reportable Disease Statistics British Medical Bulletin, Volume 18, Issue 1, 1 December 213, Pages 5 24 Education strategies Local community presentations, health fairs, etc. May is Lyme Disease Awareness Month NJDOH Websites / Disease Chapters Social Press Release / Health Alert Network Messaging Contact Information Krista M. Reale, MA, CHES New Jersey Department of Health krista.reale@doh.nj.gov NJDOH Reportable Disease Statistics After the webinar You will be sent a link to the evaluation Those seeking continuing education credits MUST complete the evaluation within 5 days Evaluation link closes after 5 days Those who do not complete the evaluation will not receive credits Kim Cervantes, MA, MPH, CIC kim.cervantes@doh.nj.gov Andrea M. Egizi, PhD andrea.egizi@co.monmouth.nj.us Occi, PhD Candidate james.occi@rutgers.edu Krista M. Reale, MA, CHES krista.reale@doh.nj.gov 12
13 Questions? 13
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